A nurse is assisting in the care of a client who is 36 weeks of gestation and reported to the clinic for a routine visit. Nurses' Notes. 0900:. Vital Signs. Physical Examination. Lungs clear to auscultation in all lobes, anterior, posterior, and lateral. Abdomen gravid and soft to palpation. Fundal height 37 cm. Facial edema observed as well as +3 edema in the lower extremities. Patellar reflex 3+, clonus negative. Fetal heart rate 158/min. Which of the following findings should the nurse report to the provider?. (Select all that apply.).

The correct answers are choices A. Blood pressure, B. Cerebral manifestations, and E. Deep tendon reflexes.

Choice A rationale:

Blood pressure is a critical parameter to monitor, especially in the third trimester. Elevated blood pressure can indicate preeclampsia, a serious condition that requires immediate attention.

Choice B rationale:

Cerebral manifestations, such as headaches or visual disturbances, can also be signs of preeclampsia. These symptoms should be reported to the provider immediately.

Choice C rationale:

The fetal heart rate of 158/min is within the normal range (110-160 beats per minute) and does not need to be reported.

Choice D rationale:

The respiratory rate is not mentioned in the provided notes, and there is no indication that it is abnormal. Therefore, it does not need to be reported.

Choice E rationale:

Deep tendon reflexes that are hyperactive (3+) can be a sign of preeclampsia. This finding should be reported to the provider.

Choice B rationale:

The correct answer is Choice B, which is "Newborn hypoglycemia.”. Newborn hypoglycemia is a potential complication associated with maternal gestational diabetes. When a pregnant woman has gestational diabetes, her blood glucose levels can be elevated, leading to increased insulin production in the fetus. After birth, the baby's insulin production continues at a high level, which can result in a rapid drop in blood glucose levels, causing hypoglycemia. This condition can be serious and requires close monitoring and timely intervention to prevent complications in the newborn.

Choice A rationale :

Placenta previa is not a complication associated with maternal gestational diabetes. Placenta previa occurs when the placenta partially or completely covers the cervix, which can lead to bleeding during pregnancy and delivery. However, this condition is not directly related to gestational diabetes, and there is no physiological rationale connecting the two.

Choice C rationale

Small for gestational age (SGA) newborn is not a direct complication of maternal gestational diabetes. SGA refers to babies who are smaller in size than expected for their gestational age. While poorly controlled diabetes during pregnancy can lead to large babies (macrosomia), it is not typically associated with small babies.

Choice D rationale

Oligohydramnios, which is a condition characterized by low levels of amniotic fluid, is not a common complication associated with maternal gestational diabetes. Oligohydramnios can be caused by various factors, but it is not specifically linked to gestational diabetes.